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General NPI Number Information
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NPI Number | 1578630653
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Entity Type | Individual
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Provider Name | FARIDA MURTUZA IZZI MD
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Gender | Female
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Dates
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Enumeration Date | 11/30/2006
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Last Update Date | 04/19/2017
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Provider Practice Location Address
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Address Line | 900 23RD ST NW
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City | WASHINGTON
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State | DC
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Zip | 20037-2342
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Country | US
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Telephone | 202-715-5109
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Fax |
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Provider Business Mailing Address
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Address Line | 13325 HORSEPEN WOODS LN
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City | HERNDON
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State | VA
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Zip | 20171-3847
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | T1733
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 0101235993
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License Number State | VA
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